Active NPI
Denise I. Fitzsimon, MD
- Pediatrics Physician
- Round Rock, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- H1960
- Practice address
- 300 University Blvd
Round Rock, TX 78665-1032 - Phone
- (512) 509-0200
- NPI assigned
- Mar 13, 2007
- Last updated
- Nov 9, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 3954 | AK | |
| Pediatrics Physician | 208000000X | MD26536 | OR | |
| Pediatrics Physician | 208000000X | MD00046928 | WA | |
| Pediatrics Physician | 208000000X | H1960 | TX | Primary |
Addresses
Primary practice location
300 University Blvd
Round Rock, TX 78665-1032
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 278407 | Medicaid | OR | |
| 218112 | Medicaid | OR |
Other names 1
- Denise I. Fitzsimon-Williams
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dfitzsimon1127337@direct.sw.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3954 | AK | MD | Pediatrics Physician |
| MD26536 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Medical Foundation of Tillamook | Current | Accepting new patients | |
| Saint Alphonsus Medical Center- Ontario Inc | Current | Accepting new patients | |
| Siskiyou Hospital, Inc. | Current | Accepting new patients | |
| Commonspirit Oregon | Current | Accepting new patients | |
| Saint Alphonsus Medical Center- Ontario Inc | Current | Accepting new patients | |
| Commonspirit Oregon | Current | Accepting new patients | |
| Northwest Medical Foundation of Tillamook | Current | Accepting new patients | |
| Saint Alphonsus Medical Center- Ontario Inc | Current | Accepting new patients |
Locations
444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256
475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507
1050 SW 3rd Ave
Ste 1600
Ontario, OR 97914
Phone (541) 881-2360
2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121
1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129
1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260
Interoperability endpoints
- dfitzsimon1127337@direct.sw.org
- dfitzsimon575934@direct.llu.edu
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba St. Anthony Hospital Profee
- Multi-Specialty Clinic/Center
- Pendleton, OR
- NPI 1831169903
-
dba Adventist Health Tillamook
- Critical Access Hospital
- Tillamook, OR
- NPI 1871575225
-
- Internal Medicine Physician
- Ontario, OR
- NPI 1093034159
-
dba Fairchild Medical Center
- Critical Access Hospital
- Yreka, CA
- NPI 1093892275
-
dba Adventist Health Medical Office - Sheridan
- Critical Access Hospital
- Sheridan, OR
- NPI 1053873919
-
- Internal Medicine Physician
- Ontario, OR
- NPI 1629397781
-
dba Saint Alphonsus Medical Center Ontario
- General Acute Care Hospital
- Ontario, OR
- NPI 1891891792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1861525636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 UNIVERSITY BLVD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786651032",
"telephone_number": "512-509-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZSIMON",
"first_name": "DENISE",
"middle_name": "I.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AK",
"license": "3954",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD26536",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00046928",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "H1960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "278407",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "218112",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dfitzsimon1127337@direct.sw.org",
"affiliation": "N",
"address_1": "300 University Blvd",
"city": "Round Rock",
"state": "TX",
"country_code": "US",
"postal_code": "786651032",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "DENISE",
"last_name": "FITZSIMON-WILLIAMS",
"middle_name": "I.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.